Literature DB >> 18071803

Pain sensation and neuromuscular stimulation during argon plasma coagulation in gastrointestinal endoscopy.

A Eickhoff1, D Hartmann, J C Eickhoff, J F Riemann, M D Enderle.   

Abstract

BACKGROUND: Argon plasma coagulation (APC) is a thermal coagulation technique that uses ionized argon for contact-free transmission of high-frequency electrical current to tissue. Prospective data on complications with the new APC-2 (VIO) system are lacking.
METHODS: A prospective trial was conducted with 152 patients treated for various gastrointestinal diseases using three modes of the APC-2. The study aimed to assess complications, focusing on the pain and neuromuscular stimulation (NMS) experienced during and after treatment. Patients reported pain and NMS using a scale ranging from 0 to 10 and were interviewed for symptoms such as tingling, paresthesia, muscle pain, and cramping or twitching. The endoscopists also graded NMS using a separate questionnaire.
RESULTS: A total of 85 males and 67 females (median age, 66 years) were enrolled in the study. All APC therapies were completed successfully. Two peri-interventional perforations were recorded. Of the 152 patients, 26 (17%) reported pain sensation during or after APC. The median pain sensation reported by the patients on the standardized scale was 3.7. The findings showed NMS in 14 (9.2%) of the 152 patients. Significantly more NMS events were seen with pulsed APC than with forced or precise APC. Additional risk factors for NMS were gender (female) and type of sedation (combination midazolam and pethidine). No complications were noted among patients with intracardiac defibrillators or cardiac pacemakers.
CONCLUSIONS: According to the findings, APC may be associated with minor complications such as pain sensation and NMS. These complications were rarely seen, but occurred more often with pulsed APC than with forced or precise APC. Physicians should be aware of these complications.

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Year:  2007        PMID: 18071803     DOI: 10.1007/s00464-007-9700-3

Source DB:  PubMed          Journal:  Surg Endosc        ISSN: 0930-2794            Impact factor:   4.584


  25 in total

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Journal:  Eur J Gastroenterol Hepatol       Date:  1997-06       Impact factor: 2.566

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Journal:  Endoscopy       Date:  1997-03       Impact factor: 10.093

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Authors:  Raphael T Villavicencio; Douglas K Rex; Emad Rahmani
Journal:  Gastrointest Endosc       Date:  2002-01       Impact factor: 9.427

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Journal:  Dis Colon Rectum       Date:  2001-12       Impact factor: 4.585

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9.  Safety and efficacy of a new high power argon plasma coagulation system (hp-APC) in lesions of the upper gastrointestinal tract.

Authors:  H Manner; A May; M Faerber; T Rabenstein; C Ell
Journal:  Dig Liver Dis       Date:  2006-05-15       Impact factor: 4.088

10.  Prospective nonrandomized comparison of two modes of argon beamer (APC) tumor desobstruction: effectiveness of the new pulsed APC versus forced APC.

Authors:  A Eickhoff; R Jakobs; D Schilling; D Hartmann; U Weickert; M D Enderle; J C Eickhoff; J F Riemann
Journal:  Endoscopy       Date:  2007-07       Impact factor: 10.093

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